Evaluation of thrombolysis and angioplasty in a porcine iliac artery thrombosis model: Application of endovascular stent-graft-induced thrombosis

PURPOSE:To develop a novel endovascular thrombosis model in the porcine ili ac artery for the evaluation of thrombolysis and angioplasty, MATERIALS AND METHODS: A stent-inversion-graft (SIG) model combining either a 3-mm or 5-mm tapered expandable polytetrafluoroethylene (ePTFE) graft at tached within a self-expandable, 10-mm nitinol stent was placed in the left common iliac artery via an ipsilateral common femoral artery approach in 2 4 pigs, When the iliac artery was thrombosed, urokinase (250,000 IU) plus h eparin (1,000 units) were pulse sprayed via a contralateral femoral approac h (n = 12), Saline pulse-spray was used as a control group (n = 12), Balloo n angioplasty was performed to eliminate the stenotic tapered graft within the stent after successful thrombolysis. The efficacy of the thrombolysis w as assessed with use of intravascular ultrasound (IVUS) and arteriogram. RESULTS: Both the 3-mm tapered and 5-mm tapered SIG models caused iliac art ery occlusion in 22 +/- 5 and 41 +/- 9 minutes, respectively, after the dep loyment. Luminal patency was re-established successfully in all occluded ar teries after urokinase infusion, Angioplasty was successful in eliminating the tapered stenosis and restoring the normal diameter in all iliac arterie s treated with urokinase, Complete thrombolysis was achieved in both models treated with urokinase, CONCLUSION: This novel endovascular approach of inducing arterial thrombosi s is simple to perform and reliably produces arterial thrombosis, The intra luminal stenosis is also amenable to angioplasty. This model is useful for the evaluation of antithrombotic treatment modality and adjunctive endovasc ular interventions.